gadgets in palliative care

The Role of Gadgets, Tools, and Mechanical Aids in Hospice and Palliative Care

As the population ages and the incidence of chronic diseases rises, the demand for high-quality palliative care has grown exponentially. Integral to the delivery of effective hospice and palliative care are gadgets, tools, and mechanical aids that assist in symptom management, promote comfort, reduce caregiver burden, and facilitate communication. These technologies serve not only to enhance the quality of care but also to empower patients to maintain autonomy and dignity in their final stages of life.

Understanding Hospice and Palliative Care

Palliative care addresses physical, emotional, spiritual, and psychosocial needs, often delivered in conjunction with curative treatments, while hospice care is typically reserved for patients expected to live six months or less and have chosen to forego curative treatment (World Health Organization, 2020). Both disciplines prioritize patient-centered care and symptom relief, which can be significantly enhanced through the appropriate use of assistive technologies.

Types of Gadgets and Tools in Hospice and Palliative Care

Communication Aids

Many terminal illnesses, such as advanced cancers or neurodegenerative diseases, impair speech or cognition. Communication tools become vital in preserving patient autonomy. Speech-generating devices (SGDs), also known as augmentative and alternative communication (AAC) devices, allow non-verbal patients to express needs and preferences. Eye-tracking systems and tablet-based apps like Proloquo2Go or Grid 3 have revolutionized communication for patients with ALS or stroke (Beukelman & Mirenda, 2013). However, these are not yet readily available in the country. We can still use, however, whiteboards, or pen and paper, in order to communicate and help our patients express themselves.

Mobility and Transfer Aids

Loss of mobility is common in terminal illness. Mechanical aids help reduce discomfort and prevent complications such as bedsores. Specialized wheelchairs with posture control and recline functions support patient mobility and reduce fatigue. Devices like Hoyer lifts allow safe transfer of non-ambulatory patients, reducing risk of injury to caregivers and patients alike. Tools such as Sara Stedy or other sit-to-stand systems help patients maintain mobility for longer, boosting morale and circulation.

Pressure Relief and Positioning Devices

Immobility increases the risk of pressure ulcers and contractures, particularly in bedridden patients. Dynamic air mattresses with alternating pressure relieve pressure points are proven to reduce the incidence of pressure ulcers (McInnes et al., 2015). Foam supports maintain body alignment and help prevent complications like aspiration or joint stiffness. Automated beds that gently rotate patients at programmed intervals reduce caregiver burden and prevent sores.

Respiratory Support Tools

Breathlessness is a common and distressing symptom in terminal conditions such as COPD, heart failure, or cancer. Portable or stationary oxygen devices provide relief from dyspnea and improve comfort at home. Devices such as CPAP or BiPAP may be used in palliative settings to reduce work of breathing, though ethical considerations must be taken into account for end-stage use (Gonzalez-Bermejo et al., 2018). Low-tech tools like fans directed at the face can also effectively reduce the sensation of breathlessness through trigeminal nerve stimulation (Bausewein et al., 2008).

Medication Management Tools

Effective symptom control depends on timely and accurate medication administration. Automated pill dispensers ensure adherence by alerting patients when it's time for a dose, reducing the risk of under or overdosing. Syringe drivers or continuous subcutaneous infusion pumps deliver a constant dose of pain relievers or antiemetics, particularly when oral administration is no longer feasible (NHS Specialist Pharmacy Service, 2019).  Some tools track adherence and transmit data to healthcare providers or caregivers for remote monitoring.

Telemedicine and Remote Monitoring

Digital health platforms enable the provision of palliative care even in remote or home-based settings. Applications like Zoom allow virtual consultations, enabling multidisciplinary care teams to follow up with patients without requiring travel. Gadgets like smartwatches or biosensors monitor vital signs (heart rate, oxygen saturation, activity levels) and alert caregivers to changes in condition (Broadbent et al., 2020). Other applications like MyPal or PalliSupport record patient-reported outcomes and help tailor treatment plans.

Nutritional and Hydration Support

Dysphagia and appetite loss are common in terminal illness. For patients requiring enteral nutrition, programmable feeding pumps deliver a controlled flow of nutrients. Tools like weighted spoons or nosey cups assist those with swallowing difficulties or tremors.

Comfort and Psycholgical Aids

Maintaining emotional well-being is as important as managing physical symptoms. Devices that play calming sounds, white noise machines, or aromatherapy diffusers can help manage anxiety and promote sleep. Emerging research supports the use of VR to provide distraction therapy or fulfill "bucket list" experiences for terminally ill patients (Niki et al., 2019). Digital legacy tools like SafeBeyond or LifeTales allow patients to leave video messages and memories for loved ones.

“The integration of these tools in palliative care has shown numerous benefits.”

The quality of life is improved by reducing symptom burden and discomfort. Increased autonomy and dignity in patients who can express their needs or manage some aspects of care is also achieved by the manipulation or utilization of tools and gadgets. Reduced caregiver stress is also seen especially when mechanical aids assist with physically demanding tasks. Continuity of care, especially in underserved areas through telehealth solutions and the use of the internet, resolves issues on lack of access to specialists.

However, the adoption of technology must always be balanced with ethical and psychosocial considerations. The risk of over-medicalization, depersonalization, or loss of human contact must be mitigated. The patient’s wishes, cultural values, and cognitive capacity should guide decisions on using assistive devices (Broom et al., 2015).  Despite the potential, there are barriers to widespread use of these technologies such as cost, training, access and infrastructure. Rural areas may lack the internet or power infrastructure to support these tools. Some patients, especially older adults, may be hesitant to use unfamiliar technology due to fear or ignorance of its benefits.

Gadgets, tools, and mechanical aids play an increasingly essential role in hospice and palliative care, offering comfort, improving quality of life, and supporting caregivers. From basic communication boards to sophisticated remote monitoring systems, these technologies allow care to be more responsive, individualized, and compassionate. Nonetheless, their use must always align with the core principles of palliative care: respect for patient autonomy, holistic care, and dignity in dying.

As technology evolves, future innovations may continue to redefine the boundaries of comfort and care at the end of life.

References

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  • Beukelman, D. R., & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs (4th ed.).

  • Paul H. Brookes. Broadbent, E., Garrett, J., Jepsen, N., Li, O., Ahn, H. S., Robinson, H., & Peri, K. (2020). Using robots at home to support patients with chronic conditions: A pilot randomized controlled trial. Journal of Medical Internet Research, 22(2), e16107. https://doi.org/10.2196/16107

  • Broom, A., Kirby, E., Good, P., Wootton, J., & Adams, J. (2015). The art of letting go: Referral to palliative care and its discontents. Social Science & Medicine, 138, 9–16. https://doi.org/10.1016/j.socscimed.2015.05.029

  • Gonzalez-Bermejo, J., Morélot-Panzini, C., & Similowski, T. (2018). Non-invasive ventilation in palliative care. Annals of Palliative Medicine, 7(3), 343–354. https://doi.org/10.21037/apm.2018.05.02

  • McInnes, E., Jammali-Blasi, A., Bell-Syer, S. E. M., Dumville, J. C., & Cullum, N. (2015). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews, (9), CD001735. https://doi.org/10.1002/14651858.CD001735.pub5

  • NHS Specialist Pharmacy Service. (2019). Syringe Driver Drug Compatibility Charts. https://www.sps.nhs.uk

  • Niki, K., Okamoto, Y., Maeda, I., Mori, I., Shima, Y., Matsuda, Y., ... & Morita, T. (2019). A novel palliative care approach using virtual reality for improving various symptoms of terminal cancer patients: A preliminary prospective study. Journal of Palliative Medicine, 22(6), 702–707. https://doi.org/10.1089/jpm.2018.0348

  • World Health Organization. (2020). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care